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Pediatric and perinatal reference intervals for immunoglobulin light chains kappa and lambda
K R Herkner1, H Salzer, A Böck
1Ludwig Boltzmann Institut für Pädiatrische Endokrinologie und Immunologie, Univ. Kinderklinik, Wien, Austria.
Insights
This study established age-related reference intervals for serum kappa and lambda light chains in children. The kappa/lambda ratio increases linearly with age, offering a new diagnostic marker in pediatric immunology.
Area of Science:
- Immunology
- Pediatric Diagnostics
- Clinical Chemistry
Background:
- Immunoglobulin light chains are crucial in pediatric diagnostics.
- Establishing age-specific reference intervals is essential for accurate interpretation.
- Previous data on pediatric light chain reference ranges is limited.
Purpose of the Study:
- To evaluate age-related reference intervals for serum kappa and lambda light chains in healthy children.
- To assess the kappa/lambda ratio's changes throughout childhood.
- To analyze light chain concentrations in preterm infants.
Main Methods:
- Serum samples from 1543 healthy children (birth to 16 years) were analyzed.
- Rate nephelometry was used for light chain quantification.
- Immunoglobulin G (IgG), IgA, and IgM levels were measured concurrently.
Main Results:
- Serum kappa and lambda light chain levels demonstrated age-dependent variations.
- The kappa/lambda ratio exhibited a near-linear increase with age, from 0.97 at 4 months to 2.21 at 15 years.
- Preterm infants showed lower IgG and light chain levels but adult-like kappa/lambda ratios.
Conclusions:
- Age-specific reference intervals for serum kappa and lambda light chains have been defined for pediatric populations.
- The age-related kappa/lambda ratio may serve as a valuable biomarker in pediatric diagnostics.
- Maternal IgG influences light chain profiles in preterm neonates.
Abstract:
In routine analysis for immunoglobulin light chains in pediatric diagnostics, the age-related reference intervals for serum kappa (kappa) and lambda (lambda) light chains were evaluated in 1543 healthy subjects (newborns to age 16 years, including 168 premature infants). Light-chain analysis was performed by rate nephelometry. IgG, IgA, and IgM were measured simultaneously, and heavy- and light-chain differences were calculated for control purposes. Results for IgG, IgA, and IgM generally agreed with reference intervals reported in the literature. kappa showed age-related changes comparable with changes in IgG concentrations, whereas lambda showed moderate fluctuations. The kappa/lambda ratio showed an almost linear increase with age, starting with 0.97 at four months and reaching the highest value of 2.21 at 15 years (mean values). Preterm infants presented with markedly low serum concentrations of IgG and corresponding light chains but with adult-type kappa/lambda ratios because of the maternal-origin IgG.